HD 3570 Social Inequality in Health - Introduction Check syllabus - only book The Immortal Life of Henrietta Lacks Key Things to Know: • Keeping up with the reading is associated with getting better grades in this class • The class films are integrated into class lectures and exercises Why do kids who If you want to learn more check out What is a job cost?
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grow up in difficult circumstances end up either being successful or just not at all? -->Inequalities and lack of opportunity are to blame for this phenomenon What will this class cover? • Health inequalities (also called health disparities) are defined as differences across racial, social, and socioeconomic groups in: 1. Quality of overall health 2. Rates of illness 3. Rates of death and mortality by age i. In some states in the U.S. the mortality rate of mothers is increasing (bad indicator) 4. Access to health care 5. Quality of health care Which state in the US is rated the "worst" for overall health of its population? Mississippi Best health = Hawaii Women live longer than men, and men abuse alcohol more than woman unless under the age of 30 Week 1 Readings Health Disparities & Health Equity: Concepts & Measurement This paper aims to clarify the concepts of health disparities/inequalities (used interchangeably here) and health equity, focusing on the implications of different definitions for measurement and hence for accountability. • Health disparity/inequality: is a difference in which disadvantaged social groups - such as the poor, racial/ethnic minorities, women, or other groups who have persistently experienced social disadvantage or discrimination - systematically experience worse health or greater health risks than more advantaged social groups • Social advantage: refers to one's relative position on a social hierarchy that is determined by wealth, power, and/or prestigeHD 3570 Social Inequality in Health - Introduction The Status Syndrome: A Challenge to Medicine What is the "status syndrome"? • Those at the bottom of the socioeconomic scale have worse health than those above them in the hierarchy • Socioeconomic differences in health are not confined to poor health for those at the bottom and good health for everyone else, rather, there is a social gradient in health for individuals who are not poor. o The higher the social position, the better the health Individuals that are lower on the social hierarchy are less likely to meet fundamental human needs for autonomy and integration into society. Failure to meet those needs result in metabolic and endocrine changes that increase risk of disease! The Social Gradient in Health is Widespread • In the U.S., income, education, and occupation have all been shown to predict mortality • The principal causes of premature mortality in black men are not diseases related to material deprivation, but instead, cardiovascular disease, violence, and HIV/AIDS Conventional Explanations The way blacks in the U.S. are worse than whites has little to do with absolute income. Instead, it has to do more with 2 fundamental human needs: autonomy and full social participation • Deprived of a clean, safe neighborhood, meaningful work, opportunities for quality children’s education, freedom from police harassment and arrest, and freedom from violence and aggression, it is harder to have control over one’s life or be a full social participant. • Lack of control and lack of social participation have a powerful influence on disease risk --> These are likely major contributors to inequality in health